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Researchers find nicotine withdrawal begins quickly

August 22, 2006

Smokers who have tried to quit are well aware of the symptoms of nicotine withdrawal: cravings for cigarettes, mood disturbances, appetite increase and sleep problems. However, it had not previously been known when withdrawal symptoms first appear. Thomas H. Brandon, Ph.D., Director of H. Lee Moffitt Cancer Center & Research Institute's Tobacco Research & Intervention Program and his research team from Moffitt and the University of South Florida study examined this and found that within 30 minutes, the abstaining smokers reported greater cravings for cigarettes. Results have been published in the most recent issue of Psychopharmacology, authored by Peter S. Hendricks, Joseph, W. Ditre, and David J. Drobes, and Brandon.

The team brought 50 pack-a-day smokers into the laboratory for four hours of testing. Half the smokers were randomly selected to continue smoking as usual, while the other half were asked to abstain from smoking for the four hours. Every half-hour these participants received a series of tests. Differences between the two groups were considered evidence of nicotine withdrawal.

Within 30 minutes, the abstaining smokers reported greater cravings for cigarettes. By one hour, they reported greater anger. Increases in anxiety, sadness, and difficulty concentrating all appeared within the first three hours. Results also show that in the first half-hour the abstaining smokers already performed more poorly on a task requiring sustained attention, and that their heart rate slowed within the first hour, another withdrawal symptom.

These symptoms doom many attempts to quit smoking, and therefore a range of smoking cessation medications have been developed to reduce their magnitude. Withdrawal symptoms represent a smoker's brain and body adjusting to being nicotine-free, and they typically peak within the first three days of quitting smoking and last for two weeks or longer.

"This study suggests that the typical smoker begins to feel somewhat out-of-sorts within an hour of his or her last cigarette," says senior author Brandon. "Although they are not yet in the throes of full withdrawal that they would experience after a day without nicotine, they can already perceive that they are not feeling quite right, and that a cigarette would offer temporary relief."

Brandon points out that when nicotine-dependent smokers are allowed to smoke at will, they average one cigarette about every 40 minutes, by which point nearly all the nicotine from their previous cigarette has left the brain.

"The study indicates that nicotine withdrawal is not only a barrier to quitting smoking, but that it likely plays a subtle role in the decision to smoke nearly every cigarette of the day," says Brandon. "Nicotine replacement (such as nicotine gum or lozenges) may help you get through the day, but really this is another good reason to quit smoking all together and enjoy life without the daily burden of nicotine withdrawal."

University of South Florida Health